Decision Support

Anticoagulation therapy for the prevention of stroke and systemic embolism in atrial fibrillation.

Important Information

This decision support tool for healthcare professionals supports the majority of recommendations relating to the diagnosis and assessment of atrial fibrillation, assessment of stroke and bleeding risks and anticoagulation in the NICE guideline on Atrial fibrillation. It also supports the NICE technology appraisal on Edoxaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation.

This tool is for use with adults (aged 18 years and over) who have suspected or diagnosed non-valvular atrial fibrillation.

This tool should not be used by persons other than UK healthcare professionals in the appropriate prescribing of anticoagulation therapy for the prevention of stroke in patients with atrial fibrillation.

National Institute for Health and Care Excellence

June 2016

The tool was developed as part of a joint working group initiative comprising the National Institute for Health and Care Excellence (NICE), Boehringer Ingelheim Ltd and Prescribing Decision Support Ltd at the Centre for Medicines Optimisation, Keele University.  All three parties committed resources to the joint working project in line with ABPI Code requirements.

The primary aims of the tool are:

Prescribers

  • To support and assist healthcare professionals in the implementation of NICE guidance for the prevention of stroke and systemic embolism in patients with atrial fibrillation
  • To provide anticoagulation treatment recommendations for the management of patients with atrial fibrillation at risk of stroke and systemic embolism - based on the individual patient profiles created by the healthcare professional user
  • To support communication and shared decision-making with patients through the use of a patient decision aid and personalised patient materials

Patients

  • To provide a practical basis - via the patient decision aid - for patients to participate in an informed discussion with a healthcare professional about their anticoagulant treatment choices in atrial fibrillation, taking into account the options available, their individual needs and preferences and potential benefits and risks.
  • To provide patients with a personalised report of their consultation

The tool is based on the following NICE guidance:

The tool also incorporates:

Further support on the local implementation of NICE guidance on the use of the novel (non-Vitamin K antagonist) oral anticoagulants in non-valvular atrial fibrillation can be found in the:

The tool is intended to support clinical decision-making and prescribing and not replace the healthcare professional’s clinical judgement.  The healthcare professional user of the tool should use their own clinical judgment when considering and/or acting upon the prompts, alerts, notes and recommendations arising from using the tool and they are responsible for checking a drug’s summary of product characteristics to inform decisions made with individual patients.

Keele University and PDS Ltd are not liable for any adverse reactions experienced by a patient as a result of a recommendation made by the tool.

This tool is only intended for use by qualified healthcare professionals working within the United Kingdom.

Developed by Prescribing Decision Support, Centre for Medicines Optimisation, School of Pharmacy, Keele University, Staffordshire ST5 5BG, UK.

Last updated on 25th July 2016, Version 1.1.0.

Developed as part of a joint working group initiative comprising the National Institute for Health and Care Excellence (NICE), Boehringer Ingelheim Ltd and Prescribing Decision Support Ltd at the Centre for Medicines Optimisation, Keele University.

Keele University and PDS Ltd reserves the right to update and change the Tool at any time in order to address changes in NICE clinical guidance and respective drug SPCs, improve functionality and reflect changing user and business needs.  Keele University / PDS Ltd also reserves the right to withdraw the Tool if and when its content is out of date and no longer consistent with NICE clinical guidance.

© 2016 Keele University
© 2016 Prescribing Decision Support Ltd